, Volume 192, Issue 4, pp 583–587 | Cite as

Thoracic Endometriosis-Related Pneumothorax Distinguished From Primary Spontaneous Pneumothorax in Females

  • Takahiro Haga
  • Hideyuki Kataoka
  • Hiroki Ebana
  • Mizuto Otsuji
  • Kuniaki Seyama
  • Koichiro Tatsumi
  • Masatoshi KuriharaEmail author



Thoracic endometriosis-related pneumothorax (TERP) is a secondary condition specific for females, but in a clinical setting, TERP often is difficult to distinguish from primary spontaneous pneumothorax (PSP) based on a relationship between the dates of pneumothorax and menstruation. The purpose of this study was to clarify the clinical features of TERP compared with PSP.


We retrospectively reviewed the clinical and histopathological files of female patients with pneumothorax who underwent video-assisted thoracoscopic surgery in the Pneumothorax Research Center during the 6-year period from January 2005 to December 2010. We analyzed the clinical differences between TERP and PSP.


The study included a total of 393 female patients with spontaneous pneumothorax, of whom 92 (23.4 %) were diagnosed as having TERP and 33.6 % (132/393) as having PSP. We identified four factors (right-sided pneumothorax, history of pelvic endometriosis, age ≥31 years, and no smoking history) that were statistically significant for predicting TERP and assigned 6, 5, 4, and 3 points, respectively, to establish a scoring system with a calculated score from 0 to 18. The cutoff values of a calculated score ≥12 yielded the highest positive predictive value (86 %; 95 % confidence interval (CI) 81.5–90.5 %) for TERP and negative predictive value (95.2 %; 95 % CI 92.3–98 %) for PSP.


TERP has several distinct clinical features from PSP. Our scoring system consists of only four clinical variables that are easily obtainable and enables us to suspect TERP in female patients with pneumothorax.


Primary spontaneous pneumothorax Thoracic endometriosis-related pneumothorax Thoracic endometriosis Pneumothorax 



The authors thank Ms. Phyllis Minick for her excellent proofreading of English writing.

Conflict of interest

None of the authors has any conflicts of interest with regard to this study.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Takahiro Haga
    • 1
    • 2
    • 5
  • Hideyuki Kataoka
    • 1
    • 5
  • Hiroki Ebana
    • 1
    • 3
    • 4
    • 5
  • Mizuto Otsuji
    • 1
    • 4
    • 5
  • Kuniaki Seyama
    • 3
    • 5
  • Koichiro Tatsumi
    • 2
  • Masatoshi Kurihara
    • 1
    • 5
    Email author
  1. 1.Pneumothorax Research Center and Division of Thoracic SurgeryNissan Tamagawa HospitalTokyoJapan
  2. 2.Department of Respirology, Graduate School of MedicineChiba UniversityChibaJapan
  3. 3.Division of Respiratory MedicineJuntendo University Faculty of Medicine and Graduate School of MedicineTokyoJapan
  4. 4.Division of Thoracic and Cardiovascular SurgeryTokyo Metropolitan Bokutoh HospitalTokyoJapan
  5. 5.The Study Group of Pneumothorax and Cystic Lung DiseasesTokyoJapan

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